Nursing Elites

1. Two people experience the same stressor yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with:

• A. A sense of purpose in life
• B. Circadian rhythm disruption
• C. Age-related renal dysfunction
• D. Excessive weight gain or loss

Correct answer: A

Rationale: A strong sense of purpose in life is associated with better stress coping mechanisms, which can enhance a person's capacity to adapt. Having a clear sense of purpose provides individuals with motivation, direction, and resilience to face challenges. Choices B, C, and D are not directly related to an increased capacity to adapt to stress. Circadian rhythm disruption, age-related renal dysfunction, and excessive weight gain or loss may have negative impacts on overall well-being and stress management.

2. During patient teaching, a young woman asks the nurse the following question: 'If I get pregnant on the 'pill,' should I continue to take it?' What is the nurse's best response?

• A. The pill has no effect on pregnancy.
• B. The pill will cause miscarriage.
• C. This is a personal choice for each woman.
• D. The pill can be harmful to the fetus and should be discontinued.

Correct answer: C

Rationale: The correct answer is 'C: This is a personal choice for each woman.' If a woman becomes pregnant while taking birth control pills, it is generally recommended to discontinue them as they can potentially harm the fetus. However, the decision to continue or discontinue the pill in case of pregnancy is ultimately a personal choice for each woman. Choice A is incorrect because birth control pills are meant to prevent pregnancy, but if a woman becomes pregnant while taking them, the situation changes. Choice B is incorrect because birth control pills do not cause miscarriage; they are intended to prevent pregnancy. Choice D is incorrect because while it is generally advised to discontinue the pill if pregnancy occurs, the decision ultimately depends on the individual circumstances and preferences of the woman.

3. A patient is being treated with amphotericin B. Which of the following statements indicates that the patient has understood the patient teaching?

• A. “The medication may cause diabetes.”
• B. “The medication will cause liver necrosis.”
• C. “The medication may cause kidney damage.”
• D. “The medication will cause pancreatitis.”

Correct answer: C

Rationale: The correct answer is C: 'The medication may cause kidney damage.' Amphotericin B is known for its potential to cause nephrotoxicity, which can manifest as kidney damage. It is crucial for the patient to be aware of this possible adverse effect. Choices A, B, and D are incorrect because amphotericin B is not typically associated with causing diabetes, liver necrosis, or pancreatitis. Therefore, these statements do not reflect an accurate understanding of the medication's side effects.

4. Medroxyprogesterone acetate (Provera) is indicated for the treatment of women with

• A. uterine bleeding.
• B. cervical cancer.
• C. ovarian cancer.
• D. fibromyalgia.

Correct answer: A

Rationale: Medroxyprogesterone acetate (Provera) is commonly used to treat conditions like abnormal uterine bleeding, amenorrhea, and endometriosis. It helps regulate the menstrual cycle and reduce excessive bleeding. Therefore, the correct answer is A. Choice B, cervical cancer, is incorrect because Provera is not indicated for the treatment of cancer. Choice C, ovarian cancer, is also incorrect as Provera is not a primary treatment for ovarian cancer. Choice D, fibromyalgia, is unrelated to the use of medroxyprogesterone acetate.

5. A public health nurse is responsible for the administration of numerous immunizations. Which of the following guidelines regarding anaphylaxis should the nurse adhere to?

• A. The patient should be observed for anaphylaxis for 1 minute after administration.
• B. The patient should be observed for anaphylaxis for 5 minutes after administration.
• C. The patient should be observed for anaphylaxis for 30 minutes after administration.
• D. The patient should be observed for anaphylaxis for 90 minutes after administration.

Correct answer: C

Rationale: The correct answer is C: 'The patient should be observed for anaphylaxis for 30 minutes after administration.' This is because anaphylaxis can occur within minutes of administration of an immunization. By observing the patient for 30 minutes, the nurse can promptly identify and manage any signs of anaphylaxis. Choices A, B, and D are incorrect as they suggest shorter or longer observation periods, which may not be sufficient to detect and respond to anaphylaxis in a timely manner.

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